The Knick on Showtime – Your New TV Habit

I hope you had a merry Christmas/Newtonmas/Whatevermas! If you are lucky enough to have some time off now and want a new show to watch for 8+ hours in a row, I am your pusherman.

I’d always loved the series House with some caveats, the plots were so formulaic, the science questionable, it was never lupus; but I had to watch it for the character the masterful Hugh Laurie had created. And even when they aren’t completely realistic, medical sitcoms are just fun, especially when you are taking human anatomy at the same time. The Knick on Cinemax fills a House-shaped hole, and then some.

House was a network series, although it did push those boundaries. The Knick is on premium cable, directed by Steven freakin Soderburg (his cinematic and atmospheric chops shine), and stars a mustachioed Clive Owen. Obviously, there’s a lot more free reign content-wise for a cable series, and The Knick definitely goes there. The similarities are with the characters; Owen’s John Thackery is, of course, a drug addict, much like Gregory House and his inspiration, Sherlock Holmes. However, in the era of heroic medicine when The Knick is set, it’s a lot easier to just dip into the cocaine or morphine that’s meant for your patients. It wasn’t like pharmacies kept track, or that the stuff was even illegal yet. And, oh yeah, opium dens were a thing back then. As in House, the hospital is in constant administrative trouble, while also acting as a test site for new innovations.

McBurney’s Point

The Knickerbocker Hospital was a real place in Victorian Era Manhattan. The show portrays a fictionalized version, and also takes lots of cues from the history of medicine while changing names and taking liberties with the details. Dr. Thackery discovers McBurney’s point, an anatomical relationship that tells a surgeon where to make the incision for an appendectomy, but of course he calls it “Thackery’s point.” I am ok with these sort of liberties. Typhoid Mary makes an appearance, and the rough outline of that historical event is portrayed, with some details altered. Thackery is partially based on William Stewart Halsted, who was surely a pioneer, but also an addict.

Typhoid Mary and Cornelia Robertson

This was an era when we thankfully finally had ether for anesthesia, and the germ theory of disease was somewhat understood; but sterile technique was just getting there and surgeons didn’t use gloves or even caps yet. That was a weird thing for me to get over visually, as a person who sees surgery most days at work. They do at least dip their hands into carbolic acid. Patients frequently bleed out and die in the operating theater, and quackery runs rampant in the medical community. Thackery is even approached by a patent medicine/snake oil salesman for a possible celebrity doctor endorsement, which he indignantly refuses (at first).

Heroic medicine in an era before gloves

The show also does a great, empathetic job with feminist and racial issues. Cornelia Robertson, played by Juliet Rylance, is the head of social programs at the Knick. Her father is on the board of directors, and conflicts of interest abound. She loves her work (which includes capturing Typhoid Mary), but is about to be married off and dragged west. Because it’s not like women need to work or should work or have any say in who they marry or where they’ll live. Cara Seymore (who I always remember at the unfortunate prostitute in American Psycho) is Sister Harriet, a nun who runs an on-the-DL abortion service. It’s pretty crazy to consider the different attitude toward abortion back then; it was still verboten, but Sister Harriet sees it as a necessary evil while still being a person of faith, an Irish Catholic one at that. The fate of single mothers back then (or a betrothed white woman impregnated by, say, a black man) was not something you would wish on anyone.

Dr. Algernon Edwards in his underground clinic

Dr. Algernon Edwards (Andre Holland) is a highly educated and accomplished man of color who is probably based on Daniel Hale Williams. He was a family friend of Cornelia’s and comes to the Knick from France to be the new assistant chief surgeon, but not without lots of pouting and hysterics from Dr. Thackery about having to work alongside one of those people. He is kept from operating in the theater (where people observe) for a while until the other surgeons grudgingly admit to needing his help with an innovative hernia procedure he had devised. He ends up making an underground clinic for black patients in the basement (who are supposed to stick to “negro hospitals”), and spends so much of his salary on equipment that he has to live in a shoddy hotel. White patients in the main ward are constantly shocked to see him or refuse to be treated by him, especially the Irish. Blood pumps had been run by hand crank operated by a tireless nurse, until Edwards devises a more efficient vacuum pump. Over time, Thackery comes to respect him more, but he is still not exactly an equal. I don’t want to spoil the plot, but he has a secret, tender relationship with a white woman and season one does not end well for him.

John Hodgman even has a cameo as the real life Dr. Henry Cotton, who thought “all mental disorders stem from disease and infection polluting the brain.” This means a mentally ill person’s teeth and other pretty useful organs such as the colon should be removed, as these structures are teeming with bacteria. He mentions preemptively removing his own children’s teeth; cementing the association between surgeons and probable sociopathy that many of us already have. He removes Dr. Gallinger’s (another chief surgeon) wife’s teeth after she has a sort of psychotic break resulting from the death/neglect of two adopted babies,

The idea of sharing research was still somewhat in its infancy, and discoveries where being made pretty frequently. Thackery gets obsessed with figuring out blood types and doesn’t want to work with a “rival” surgeon who has been researching it already, he wants to beat him to it and get all the credit. His cocaine-induced paranoia doesn’t help. He tests one of his theories on a dying little girl and ends up speeding her death instead. He and a protege test an intrauterine device to prevent bleeding out from placenta previa on willing prostitutes. This all makes it really easy to appreciate IRBs in this day and age.

So, unless you are the squeamish type (and probably have stopped reading by now anyways), I highly recommend this series for your TV marathon needs. The show is currently in between the first and second seasons, and will air season two on Fridays. You may have to befriend someone with a MaxNow login to see season one if you don’t get Cinemax, but I promise it’s worth it. Season one ended with plenty of cliffhangers; and I patiently await season two, which was given the green light in July.